CARDIAC NCLEX TEST QUESTIONS AND
CORRECT ANSWERS
The nurse is caring for a client with an arterial line. How does the nurse recognize that the
client is at risk for insufficient perfusion of body organs?
A. Right atrial pressure is 4 mm Hg.
B. Mean arterial pressure (MAP) is 58 mm Hg.
C. Pulmonary artery wedge pressure (PAWP) is 7 mm Hg.
D. PO2 is reported as 78 mm Hg.
B. Mean arterial pressure (MAP) is 58 mm Hg.
To maintain tissue perfusion to vital organs, the MAP must be at least 60 mm Hg. A MAP of
between 60 and 70 mm Hg is necessary to maintain perfusion of major body organs such as the
kidneys and brain. An arterial line will not measure atrial pressure, PAWP, or oxygenation.
Normal right atrial pressure is 1 to 8 mm Hg. Normal PAWP is 4 to 12 mm Hg. A normal PO2 is
greater than 75 mm Hg.
The nurse in a coronary care unit interprets information from hemodynamic monitoring. The
client has a cardiac output of 2.4 L/min. Which action should be taken by the nurse?
A. No intervention is needed; this is a normal reading.
B. Collaborate with the health care provider to administer a positive inotropic agent.
,C. Administer a STAT dose of metoprolol (Lopressor).
D. Ask the client to perform the Valsalva maneuver.
B. Collaborate with the health care provider to administer a positive inotropic agent.
A positive inotropic agent will increase the force of contraction (stroke volume [SV]), thus
increasing cardiac output (CO). Recall that SV × HR = CO (heart rate [HR]). Normal cardiac
output is 4 to 7 L/min. The beta blocker metoprolol (Lopressor) has side effects of bradycardia
and decreased contractility; cardiac output would be further reduced. The Valsalva maneuver,
or bearing down, will decrease the heart rate and thus cardiac output.
Which client should the charge nurse assign to a graduate RN who has completed 2 months of
orientation to the coronary care unit?
A. Client with a new diagnosis of heart failure who needs a pulmonary artery catheter
inserted
B. Client who has just arrived after a coronary arteriogram and has vital signs requested every
15 minutes
C. Client with acute electrocardiographic changes who is requesting nitroglycerin for left
anterior chest pain
D. Client who has many questions about the electrophysiology studies (EPS) scheduled for
today
, B. Client who has just arrived after a coronary arteriogram and has vital signs requested every
15 minutes
The client returning from angiography is stable, requiring vital signs and checks of the insertion
site every 15 minutes; this is within the scope of practice of a newly licensed RN. An
experienced critical care nurse is needed to assist with insertion of a pulmonary artery catheter
for hemodynamic monitoring. A client with electrocardiographic changes is potentially
unstable; the experienced nurse will need to monitor the electrocardiogram, administer
nitroglycerin, and identify additional interventions as needed. The experienced critical care
nurse needs to provide extensive teaching about the invasive procedure of EPS; the newly
licensed nurse just off orientation may not have the depth of knowledge to perform this
teaching independently.
Which action does the nurse delegate to experienced unlicensed assistive personnel (UAP)
working in the cardiac catheterization laboratory?
A. Assess preprocedure medications the client took that day.
B. Have the client sign the consent form before the procedure is performed.
C. Educate the client about the need to remain on bedrest after the procedure.
D. Obtain client vital signs and a resting electrocardiogram (ECG).
D. Obtain client vital signs and a resting electrocardiogram (ECG).
Vital signs and 12-lead ECGs can be obtained by UAP. The health care provider will explain the
CORRECT ANSWERS
The nurse is caring for a client with an arterial line. How does the nurse recognize that the
client is at risk for insufficient perfusion of body organs?
A. Right atrial pressure is 4 mm Hg.
B. Mean arterial pressure (MAP) is 58 mm Hg.
C. Pulmonary artery wedge pressure (PAWP) is 7 mm Hg.
D. PO2 is reported as 78 mm Hg.
B. Mean arterial pressure (MAP) is 58 mm Hg.
To maintain tissue perfusion to vital organs, the MAP must be at least 60 mm Hg. A MAP of
between 60 and 70 mm Hg is necessary to maintain perfusion of major body organs such as the
kidneys and brain. An arterial line will not measure atrial pressure, PAWP, or oxygenation.
Normal right atrial pressure is 1 to 8 mm Hg. Normal PAWP is 4 to 12 mm Hg. A normal PO2 is
greater than 75 mm Hg.
The nurse in a coronary care unit interprets information from hemodynamic monitoring. The
client has a cardiac output of 2.4 L/min. Which action should be taken by the nurse?
A. No intervention is needed; this is a normal reading.
B. Collaborate with the health care provider to administer a positive inotropic agent.
,C. Administer a STAT dose of metoprolol (Lopressor).
D. Ask the client to perform the Valsalva maneuver.
B. Collaborate with the health care provider to administer a positive inotropic agent.
A positive inotropic agent will increase the force of contraction (stroke volume [SV]), thus
increasing cardiac output (CO). Recall that SV × HR = CO (heart rate [HR]). Normal cardiac
output is 4 to 7 L/min. The beta blocker metoprolol (Lopressor) has side effects of bradycardia
and decreased contractility; cardiac output would be further reduced. The Valsalva maneuver,
or bearing down, will decrease the heart rate and thus cardiac output.
Which client should the charge nurse assign to a graduate RN who has completed 2 months of
orientation to the coronary care unit?
A. Client with a new diagnosis of heart failure who needs a pulmonary artery catheter
inserted
B. Client who has just arrived after a coronary arteriogram and has vital signs requested every
15 minutes
C. Client with acute electrocardiographic changes who is requesting nitroglycerin for left
anterior chest pain
D. Client who has many questions about the electrophysiology studies (EPS) scheduled for
today
, B. Client who has just arrived after a coronary arteriogram and has vital signs requested every
15 minutes
The client returning from angiography is stable, requiring vital signs and checks of the insertion
site every 15 minutes; this is within the scope of practice of a newly licensed RN. An
experienced critical care nurse is needed to assist with insertion of a pulmonary artery catheter
for hemodynamic monitoring. A client with electrocardiographic changes is potentially
unstable; the experienced nurse will need to monitor the electrocardiogram, administer
nitroglycerin, and identify additional interventions as needed. The experienced critical care
nurse needs to provide extensive teaching about the invasive procedure of EPS; the newly
licensed nurse just off orientation may not have the depth of knowledge to perform this
teaching independently.
Which action does the nurse delegate to experienced unlicensed assistive personnel (UAP)
working in the cardiac catheterization laboratory?
A. Assess preprocedure medications the client took that day.
B. Have the client sign the consent form before the procedure is performed.
C. Educate the client about the need to remain on bedrest after the procedure.
D. Obtain client vital signs and a resting electrocardiogram (ECG).
D. Obtain client vital signs and a resting electrocardiogram (ECG).
Vital signs and 12-lead ECGs can be obtained by UAP. The health care provider will explain the
